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BackTable Vascular & Interventional

Ep. 377 Management of HCC: Focus on Radiation Segmentectomy Part 1 with Dr. Juan Gimenez and Dr. Tyler Sandow

Oct 23, 2023
Dr. Juan Gimenez and Dr. Tyler Sandow, experienced interventional radiologists, discuss the management of hepatocellular carcinoma (HCC). They cover topics such as building strong relations with transplant surgeons, working-up patients with HCC, effective interventional oncology services, and factors that guide their treatment plan using the Barcelona Clinic Liver Cancer (BCLC) staging algorithm. Stay tuned for Part 2 of this discussion.
24:03

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Quick takeaways

  • Effective stratification of patients based on tumor stage and timely imaging are crucial for treatment planning and prioritization.
  • The evolution of interventional oncology, particularly the use of Y90 therapy, has improved outcomes in hepatocellular carcinoma by incorporating a multidisciplinary approach and selecting appropriate treatment modalities for each patient.

Deep dives

Stratification of Patients and Importance of Timely Imaging

The podcast discusses the stratification of patients based on tumor stage and the need for timely imaging. Patients with more advanced stage tumors are prioritized for procedures, while those with early-stage tumors can wait longer. The importance of having imaging done within 30 days is emphasized. Biopsy is generally avoided unless absolutely necessary, as the recurrence of tumors along the biopsy track can lead to the patient being dropped from the transplant list. In cases where biopsy is needed but criteria for hepatocellular carcinoma (HEC) are not met, mapping and biopsy can be done simultaneously to save patients an extra appointment and avoid delays in care.

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